双侧大脑前动脉梗死区临床特点及发病机制探讨

目的探讨双侧大脑前动脉分布区梗死的临床特点和机制。方法回顾分析3例急性双侧ACA分布区脑梗死患者的临床特点和头MRI、MRA等资料。结果 3例患者均有脑血管病危险因素,包括高血压、糖尿病、吸烟、高HCY等。临床症状包括淡漠、欣快、不同程度肢体瘫痪和尿便障碍。存在严重的动脉硬化和(或)血管变异。结论情感障碍、肢体瘫痪和尿便障碍是主要临床表现,ACA解剖变异伴ICA/ACA局部狭窄或双侧ACA和MCA严重狭窄是双侧ACA分布区梗死发病的重要因素。     

低分子肝素治疗椎-基底动脉供血不足的疗效观察

我院用低分子肝素治疗椎 -基底动脉供血不足 42例 ,现报告如下。1　资料与方法1 1　病例选择　本组病人诊断依据〔1〕:( 1)发作性眩晕、呕吐、复视。 ( 2 )一侧或两侧视力障碍。 ( 3)一侧或两侧肢体感觉障碍 ,平衡、协调及运动障碍。 ( 4 )脑干听觉诱发电位 ,Ⅲ波波幅低平 ,分化不良 ,潜伏期延长。除外耳源性眩晕及脑干、小脑非缺血型疾病后共 83例病人 ,按先后顺序随机分为两组。治疗组 42例男 2 7例 ,女 15例 ,年龄 39～ 6 4岁 ,平均 5 1岁。对照组 41例 ,男 2 5例 ,女 16例 ,年龄 41～ 6 3岁 ,平均 5 1 6岁。1 2　方法　治疗组给予低分子…     

青年脑出血的病因及危险因素分析

目的探讨青年脑出血的危险因素及病因。方法回顾分析我院2008-01—2014-01收治的青年脑出血患者的临床资料。结果青年脑出血共779例,男性多于女性。病因从高到底依次为高血压、不明原因、血管畸形、妊娠/产褥期、瘤卒中、血液系统疾病、烟雾病和系统性红斑狼疮。危险因素为高血压、血脂异常、饮酒、心脑血管病家族史、吸烟、糖尿病和既往卒中史。18~31年龄组与32~45年龄组比,脑血管畸形发病比例明显增高(P0.05)。32~45年龄组与18~31年龄组比较,高血压脑出血比例明显增高(P0.05)。结论年龄增长脑出血比例增加,男性多于女性;高血压是主要病因,其次是脑血管畸形;高血压史、吸烟饮酒、血脂异常可能与青年脑出血有关。     

电针对脑卒中患者软瘫肢体肌张力及运动功能的影响

Objective To investigate the effects of electro-acupuncture on muscular tension and motor function in the flaccid,paralytic limbs of stroke survivors.Methods Seventy-two stroke survivors with flaccid,paralytic limbs were divided randomly into a control group and an electro-acupuncture group.Both grourps received routine therapy and rehabilitation training,but the electro-acupuncture group was also treated with electro-acupuncture.Muscular tension and motor function in the flaccid,paralytic limbs in both groups were evaluated by modified Ashworth scale (MAS)and Fugl-Meyer scores before treatment and at the end of 4 weeks.Results After treatment,in 24 patients of the electro-acupuncture group and 10 patients of the control group muscular tension had increased 1-2 grades.The effectiveness rate(68.57%)in the electro-acupuncture group wag higher significantly than that(27.03%)in the control group(P＜0.01).Fugl-Meyer scores in the electro-acupuncture group were significantlv higher than those in the control group(P＜0.01).Conclusion Electro-acupuncture supplementing traditional rehabilitation improves muscle tension in flaccid,paralytic limbs and promotes the recovery of motor flunction after stroke.     

电针对脑卒中患者软瘫肢体肌张力及运动功能的影响

Objective To investigate the effects of electro-acupuncture on muscular tension and motor function in the flaccid,paralytic limbs of stroke survivors.Methods Seventy-two stroke survivors with flaccid,paralytic limbs were divided randomly into a control group and an electro-acupuncture group.Both grourps received routine therapy and rehabilitation training,but the electro-acupuncture group was also treated with electro-acupuncture.Muscular tension and motor function in the flaccid,paralytic limbs in both groups were evaluated by modified Ashworth scale (MAS)and Fugl-Meyer scores before treatment and at the end of 4 weeks.Results After treatment,in 24 patients of the electro-acupuncture group and 10 patients of the control group muscular tension had increased 1-2 grades.The effectiveness rate(68.57%)in the electro-acupuncture group wag higher significantly than that(27.03%)in the control group(P＜0.01).Fugl-Meyer scores in the electro-acupuncture group were significantlv higher than those in the control group(P＜0.01).Conclusion Electro-acupuncture supplementing traditional rehabilitation improves muscle tension in flaccid,paralytic limbs and promotes the recovery of motor flunction after stroke.     

脑出血急性期血肿扩大原因分析

目的探讨影响脑出血急性期血肿扩大的相关因素。方法回顾分析我科近四年来收治的486例脑出血患者中136例急性期病情加重者的临床资料。结果血肿形态不规则、丘脑部位出血、血压过高超早期应用大剂量甘露醇等脱水剂病例血肿扩大发生率高。急性期血肿扩大患者死亡率高。结论导致脑出血急性期血肿扩大的相关因素较多,急性期血肿扩大是导致病情加重及死亡的主要因素,正确判断急性期血肿扩大因素将有助于改善预后。     

成人再发性化脓性脑膜炎28例临床特征分析

目的 探讨成人再发性化脓性脑膜炎(PM)的临床特征.方法 回顾性分析28例成人再发性PM(观察组,A组)的临床特征及治疗方法,并与随机纳入的41例首发性PM(对照组,B组)进行对照分析.结果 28例再发性PM患者中,存在脑脊液漏21例(75.00％),有头外伤史14例(53.57％),脑部肿瘤手术史9例(32.15％),与B组比较差异有统计学意义(P＜0.05);腰穿脑脊液外观呈乳白色、米泔样或黄色浑浊,实验室明确,20例致病菌中以葡萄球菌所致比例最高(9例,45.00％),肺炎球菌3例(15.00％),绿脓杆菌2例(10.00％),与B组有所不同.合并脑积水3例,2例进行了脑室外引流联合经脑室应用抗生素和地塞米松治疗,疗效满意.结论 成人再发性PM主要为有脑脊液漏的患者,合并脑积水者可采用脑室外引流联合经脑室用药的治疗方案.     

电针对脑卒中患者软瘫肢体肌张力及运动功能的影响

Objective To investigate the effects of electro-acupuncture on muscular tension and motor function in the flaccid,paralytic limbs of stroke survivors.Methods Seventy-two stroke survivors with flaccid,paralytic limbs were divided randomly into a control group and an electro-acupuncture group.Both grourps received routine therapy and rehabilitation training,but the electro-acupuncture group was also treated with electro-acupuncture.Muscular tension and motor function in the flaccid,paralytic limbs in both groups were evaluated by modified Ashworth scale (MAS)and Fugl-Meyer scores before treatment and at the end of 4 weeks.Results After treatment,in 24 patients of the electro-acupuncture group and 10 patients of the control group muscular tension had increased 1-2 grades.The effectiveness rate(68.57%)in the electro-acupuncture group wag higher significantly than that(27.03%)in the control group(P＜0.01).Fugl-Meyer scores in the electro-acupuncture group were significantlv higher than those in the control group(P＜0.01).Conclusion Electro-acupuncture supplementing traditional rehabilitation improves muscle tension in flaccid,paralytic limbs and promotes the recovery of motor flunction after stroke.     

出血脑梗死老年患者66例临床疗效分析

目的分析出血脑梗死老年患者临床疗效。方法通过观察我院66例出血脑梗死老年患者的临床治疗效果,分析其疗效。结果 66例出血脑梗死老年患者中,有45名治疗痊愈已出院,11名留院观察,虽有轻微的口眼歪斜和语言障碍,但生活基本上可以自理,5名有半身不遂和偏瘫后遗症患者已出院,与入院时比较,有了很大好转,另有5名患者因肺部感染严重和大量出血,没有及时治疗导致死亡。结论出血脑梗死老年患者发病的时间短,其症状就会很严重,所以,对患者及时的进行诊断治疗是减少出血脑梗死老年患者病死率的关键。     

金纳多治疗脑梗塞51例疗效观察

我院对１０２例首次发病的急性脑梗塞病人分别给予金纳多和低分子右旋糖酐进行治疗。现报告如下： １ 资料与方法 １.１ 病例选择：１０２例均为首次发病的住院病人,病程在一周以内。均符合全国第四届脑血管病学术会议制订的诊断标准［１］,并经ＣＴ或 ＭＲＩ证实。按１９９５年全国第四届脑血管病学术会议所定脑卒中患者神经功能缺损程度进行评分、分型。 １．２ 分组：将１０２例病人随机分为两组：治疗组５１例,男３０例,女２１例。年龄４１～７９岁,平均年龄６４．５岁。其中重型１６例,中型２７例,轻型８例。对照组５１例,男３…